Is it time now to stop searching for other tumor markers for HCC apart from alpha-fetoprotein?

2021 ◽  
Vol 4 (1) ◽  
pp. 26-28
Author(s):  
Ahmed Esmaiel
Keyword(s):  
Tumor Marker ◽  
Tumor Markers ◽  
Alpha Fetoprotein ◽  
Diagnosis And Prognosis ◽  
Standard Marker

It’s a dilemma; does AFP still a standard marker in the diagnosis and prognosis of HCC or do we need another marker? Until now, no other tumor marker showed promising results in comparison to alpha-fetoprotein.

scholarly journals Normal Alpha-Fetoprotein Hepatocellular Carcinoma: Are They Really Normal?

2019 ◽  
Vol 8 (10) ◽  
pp. 1736 ◽  
Author(s):  
Chao-Wei Lee ◽  
Hsin-I Tsai ◽  
Wei-Chen Lee ◽  
Shu-Wei Huang ◽  
Cheng-Yu Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Marker ◽  
Tumor Markers ◽  
Cox Regression ◽  
Hepatitis Virus ◽  
Significant Risk ◽  
Disease Free Survival ◽  
Alpha Fetoprotein ◽  
Virus Infections ◽  
Preoperative Serum

Introduction: serum alpha-fetoprotein (AFP) was routinely employed as a tumor marker for screening, diagnosis, and treatment follow-up of hepatocellular carcinoma (HCC). However, a substantial proportion of HCC patients had normal AFP level even at an advanced disease status. Few studies to date had tried to explore the nature and behavior of this normal AFP HCC (N-HCC). The purpose of this study was to investigate the clinicopathological characteristics and survival outcome of N-HCC after operation. In addition, potential tumor markers for N-HCC were also sought in an attempt to augment diagnostic ability. Methods: between 2005 and 2015, patients with hepatocellular carcinoma who were treated with hepatectomy in Chang Gung Memorial Hospital Linkou branch were divided into two groups according to their preoperative serum AFP level (<15 ng/mL: NHCC; ≥15 ng/mL: abnormal AFP HCC (A-HCC)). Patient demographic data and clinicopathological variables were collected. Kaplan–Meier and Cox regression multivariate analyses were performed to identify significant risk factors for disease-free survival (DFS) and overall survival (OS) for N-HCC. ELISA and immunohistochemical (IHC) studies were employed to determine the diagnostic accuracy of various tumor markers. Results: a total of 1616 patients (78% male) who underwent liver resection for HCC were included in this study. Of them, 761 patients (47.1%) were N-HCC. N-HCC patients were significantly older with more comorbidities and less hepatitis virus infections. Furthermore, N-HCC had fewer early recurrences (49.6% vs. 60.8%, p < 0.001) and better DFS (44.6 months vs. 23.6 months, p < 0.001) and OS (94.5 months vs. 81.7 months, p < 0.001). Both ELISA and IHC studies demonstrated that glypican-3 (GPC3) would be a promising diagnostic tumor marker for N-HCC. Conclusion: N-HCC patients were significantly older and had less hepatitis virus infections or cirrhosis. Their tumors tended to be smaller, less vascular invaded, and well-differentiated. The carcinogenesis of N-HCC may thus not be identical to that of typical HCC. GPC3 would be a promising tumor marker for diagnosing N-HCC. Further study is warranted to validate our findings.

scholarly journals Publication of Tumor Marker Research Results: The Necessity for Complete and Transparent Reporting

2012 ◽  
Vol 30 (34) ◽  
pp. 4223-4232 ◽  
Author(s):  
Lisa M. McShane ◽  
Daniel F. Hayes
Keyword(s):  
Tumor Marker ◽  
Tumor Markers ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Clinical Utility ◽  
The Body ◽  
Selective Reporting ◽  
Effectiveness Research ◽  
Study Quality ◽  
Transparent Reporting

Clinical management decisions for patients with cancer are increasingly being guided by prognostic and predictive markers. Use of these markers should be based on a sufficiently comprehensive body of unbiased evidence to establish that benefits to patients outweigh harms and to justify expenditure of health care dollars. Careful assessments of the clinical utility of markers by using comparative effectiveness research methods are urgently needed to more rigorously summarize and evaluate the evidence, but multiple factors have made such assessments difficult. The literature on tumor markers is plagued by nonpublication bias, selective reporting, and incomplete reporting. Several measures to address these problems are discussed, including development of a tumor marker study registry, greater attention to assay analytic performance and specimen quality, use of more rigorous study designs and analysis plans to establish clinical utility, and adherence to higher standards for reporting tumor marker studies. More complete and transparent reporting by adhering to criteria such as BRISQ [Biospecimen Reporting for Improved Study Quality] criteria for reporting details about specimens and REMARK [Reporting Recommendations for Tumor Marker Prognostic Studies] criteria for reporting a multitude of aspects relating to study design, analysis, and results, is essential for reliable assessment of study quality, detection of potential biases, and proper interpretation of study findings. Adopting these measures will improve the quality of the body of evidence available for comparative effectiveness research and enhance the ability to establish the clinical utility of prognostic and predictive tumor markers.

Proteomic Approaches to Tumor Marker Discovery

2002 ◽  
Vol 126 (12) ◽  
pp. 1518-1526 ◽  
Author(s):  
Alex J. Rai ◽  
Zhen Zhang ◽  
Jason Rosenzweig ◽  
Ie-ming Shih ◽  
Thang Pham ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Tumor Marker ◽  
Tumor Markers ◽  
Tumor Resection ◽  
Rapid Screening ◽  
Neoplastic Disease ◽  
Proteomic Profiling ◽  
Bioinformatics Tools ◽  
Potential Biomarkers

Abstract Context.—Current tumor markers for ovarian cancer still lack adequate sensitivity and specificity to be applicable in large populations. High-throughput proteomic profiling and bioinformatics tools allow for the rapid screening of a large number of potential biomarkers in serum, plasma, or other body fluids. Objective.—To determine whether protein profiles of plasma can be used to identify potential biomarkers that improve the detection of ovarian cancer. Design.—We analyzed plasma samples that had been collected between 1998 and 2001 from patients with sporadic ovarian serous neoplasms before tumor resection at various International Federation of Gynecology and Obstetrics stages (stage I [n = 11], stage II [n = 3], and stage III [n = 29]) and from women without known neoplastic disease (n = 38) using proteomic profiling and bioinformatics. We compared results between the patients with and without cancer and evaluated their discriminatory performance against that of the cancer antigen 125 (CA125) tumor marker. Results.—We selected 7 biomarkers based on their collective contribution to the separation of the 2 patient groups. Among them, we further purified and subsequently identified 3 biomarkers. Individually, the biomarkers did not perform better than CA125. However, a combination of 4 of the biomarkers significantly improved performance (P ≤ .001). The new biomarkers were complementary to CA125. At a fixed specificity of 94%, an index combining 2 of the biomarkers and CA125 achieves a sensitivity of 94% (95% confidence interval, 85%–100.0%) in contrast to a sensitivity of 81% (95% confidence interval, 68%–95%) for CA125 alone. Conclusions.—The combined use of bioinformatics tools and proteomic profiling provides an effective approach to screen for potential tumor markers. Comparison of plasma profiles from patients with and without known ovarian cancer uncovered a panel of potential biomarkers for detection of ovarian cancer with discriminatory power complementary to that of CA125. Additional studies are required to further validate these biomarkers.

scholarly journals Introduction of new tumor marker age score in clinical practice: Validity evaluation for differentiation benign from malignant adnexal masses

2012 ◽  
Vol 59 (3) ◽  
pp. 49-56
Author(s):  
Ivana Likic-Ladjevic ◽  
Milan Terzic ◽  
Nebojsa Ladjevic ◽  
Jelena Dotlic ◽  
Igor Pilic ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Tumor Marker ◽  
Tumor Markers ◽  
Ca 125 ◽  
Benign Tumors ◽  
Tumor Type ◽  
Adnexal Masses ◽  
Combined Tumor ◽  
Adnexal Tumor ◽  
Adnexal Tumors

OBJECTIVE: The aim of the study was to examine several tumor markers and their correlation with pathohistological findings in patients with adnexal masses. METHODS: Study involved 139 patients, 84 of them with benign, 47 with malignant and 8 with borderline adnexal tumor. Levels of CA 125, CA 19-9, CEA and CA 15-3 were obtained preoperatively and assessed regarding the specific pathohistological diagnose and the patient?s age. Obtaining these results led us to divide the patient?s CA 125 levels with age and by doing that we have attained a new Tumor Marker Age score (TMA score). Results: Patients with malignant adnexal tumors had significantly higher levels of CEA (p<0.05), CA 125, CA 19-9 and CA 15-3 tumor markers (p<0.01), in comparison with patients with benign tumors. TMA score highly statistically correlate with the tumor type (benignant/malignant). CONCLUSIONS: With the increase of tumor marker levels and the patient?s age the malignant nature of adnexal tumors is more often. Results of our study highlight the importance of the use of combined tumor markers (at least CA-125 and CA 19-9) in women with adnexal masses. Those levels along with the patient?s age and new TMA score could preoperatively predict malignant nature of the tumor.

scholarly journals SERUM TUMOR MARKERS

2006 ◽  
Vol 13 (01) ◽  
pp. 1-10
Author(s):  
FAISAL BILAL LODHI ◽  
DR IFTIKHAR ◽  
MUHAMMAD ALI ◽  
Riaz Hussain
Keyword(s):  
Tumor Marker ◽  
Tumor Markers ◽  
Specific Antigen ◽  
Germ Cell Tumors ◽  
Metastatic Breast ◽  
Chemotherapeutic Agents ◽  
Response To Therapy ◽  
Ca 125 ◽  
Care Practice ◽  
Monitoring Response

With the advent of new generations of chemotherapeutic agents andadvances in radiation therapy in the management of malignancies, an understanding of tumor markers is becomingincreasingly important. These soluble molecules in the blood are usually glycoproteins detected by monoclonalantibodies. Each tumor marker has a variable profile of usefulness for screening, determining diagnosis and prognosis,assessing response to therapy, and monitoring for cancer recurrence. Monoclonal antibodies are used to detect serumantigens associated with specific malignancies. These tumor markers are most useful for monitoring response totherapy and detecting early relapse. With the exception of Prostate-Specific Antigen (PSA), tumor markers do not havesufficient sensitivity or specificity for use in screening. Cancer Antigen (CA) 27.29 most frequently is used to followresponse to therapy in patients with metastatic breast cancer. Carcinoembryonic antigen is used to detect relapse ofcolorectal cancer, and CA 19-9 may be helpful in establishing the nature of pancreatic masses. CA 125 is useful forevaluating pelvic masses in postmenopausal women, monitoring response to therapy in women with ovarian cancer,and detecting recurrence of this malignancy. Alpha-fetoprotein (AFP), a marker for hepatocellular carcinoma,sometimes is used to screen highly selected populations and to assess hepatic masses in patients at particular riskfor developing hepatic malignancy. Testing for the beta subunit of human chorionic gonadotropin (b-hCG) is an integralpart of the diagnosis and management of gestational trophoblastic disease. Combined AFP and b-hCG testing is anessential adjunct in the evaluation and treatment of nonseminomatous germ cell tumors, and in monitoring theresponse to therapy. AFP and b-hCG also may be useful in evaluating potential origins of poorly differentiatedmetastatic cancer. PSA is used to screen for prostate cancer, detect recurrence of the malignancy, and evaluatespecific syndromes of adenocarcinoma of unknown primary. This review article describes the use of common tumormarkers in primary care practice. Particular emphasis is given to when these tests should be ordered and to commonfactors that influence the interpretation of tumor marker levels.

Adaptation of chemotherapy to the decline tumor markers in patients with poor prognosis nonseminomatous germ cell tumors:Real-world French experience.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 385-385
Author(s):  
Marion Rolland ◽  
Sara Faouzi ◽  
Leonor Chaltiel ◽  
Clement Dumont ◽  
Lionnel Geoffrois ◽  
...  
Keyword(s):  
Germ Cell ◽  
Tumor Marker ◽  
Tumor Markers ◽  
Poor Prognosis ◽  
Complete Response ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Cell Transplant ◽  
French Experience ◽  
Prognosis Group

385 Background: Personalized chemotherapy based on tumor marker decline is the new standard in poor prognosis germ-cell tumor in Europe since 2014 (GETUG 13, Lancet, Fizazi et al). The purpose of this study was to analyze the reproducibility of the princeps study in patients not selected in clinical routine between 2014 and 2018. Methods: Patients (pts) were eligible if they had at least one criteria of IGCCCG classification for poor prognosis group. They had to be treated according the study terms of GETUG 13 study and did not received prior treatment. They had to received 1 BEP (Bleomycin, Etoposide, Cisplatin). Tumor markers (HCG and AFP) were dosed between day 18 and 21. Then, they received 3 additional BEP if they had favorable tumor marker decline or intensive chemotherapy if they had unfavorable decline. Results: This retrospective study included 104 patients in 14 french centers treated between 2013 and 2018: 22,1 % (n = 23) in the favorable group (Fav), 77,9 % (n = 81) in the unfavorable group (Unfav). Thirty-two pts had PS ≥ 2. In Unfav, there were more pts with HCG > 50 000 UI/L (44,2 % vs 13 %, p = 0,0067), neutrophil-to-lymphocyt ratio was also higher (median 6,4 vs 4,5, p = 0,0199). At cycle 1, all pts received BEP in Fav and 87,5 % (n = 70) in Unfav. After chemotherapy and surgery, 65,2 % in Fav and 41,3 % in Unfav obtained complete response. At 30 months (median follow-up), Fav-OS was 80,5 % (IC95% 55,8 – 92,2) and Unfav-OS was 64,4 % (IC95% 52 – 74,4). At 30 months, rates were 69,6 % (IC95% 46,6 -84,2) and 63.5 % (IC95% 51,9 – 73) respectively. In GETUG 13 study, 3-years OS was 84 % in Fav and 73 % on Unfav; 3-years PFS was 70 % and 59 % respectively. Seven pts died because of toxicity in Unfav (No one in Fav). Neuropathy, anemia and thrombopenia were more frequent in Unfav. Salvage high-dose chemotherapy with stem-cell transplant was required in 4 (66,7 %) pts in Fav and 8 (36,4 %) pts in Unfav. Conclusions: This study showed a reproducibility of the princeps study in terms of PFS and OS. Toxicity seemed more important in real world. For the congress, results will be reported with 50 additional pts.

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